"What is intuitive to people is not necessarily intuitive to physicians," Brotman tells WebMD. "Emotional stress, conceptually, is the same thing for cardiovascular risk as physical stress. But a lot of doctors blow that off, because they think emotional stress is a psychological problem, not a physical problem."

To overcome this false impression, Brotman and colleagues reviewed recent studies looking at the short- and long-term effects of emotional stress on the heart. Their resulting report, "The Cardiovascular Toll of Stress," appears in the Sept. 22 issue of The Lancet.

"In the hospital, I see people under all sorts of stress all the time -- and I see what happens to bodies under stress," Brotman says. "Our study illustrates how important the body's stress responses are in precipitating cardiovascular effects."

Heartache, Heart Harm

Psychological disorders, personality types, and other psychological stressors are linked to various heart problems:

Emotional trauma -- such as the death of a spouse, mental or physical abuse, or posttraumatic stress disorder -- increases risk of heart attack and heart death.

People with type D personalities (characterized by pessimistic emotions and inability to share emotions with others) and type A personalities (characterized by anxiety directed outward as aggressive, irritable, or hostile behaviors) are more likely than others to suffer heart attacks.

People with angry or hostile temperaments are more likely than others to suffer heart death.

Acute fear, grief, startling, or anger can cause "stunned heart." Wallops of emotion also can cause sudden death due to life-threatening abnormal heart rhythm.